Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지
DOI QR코드

DOI QR Code

Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study

  • Jang, Min Jeong (Department of Pediatrics, Nowon Eulji Medical Center, Eulji University) ;
  • Kim, Yong Joo (Department of Pediatrics, Hanyang University Seoul Hospital) ;
  • Hong, Shinhye (Department of Pediatrics, Hanyang University Seoul Hospital) ;
  • Na, Jaeyoon (Department of Pediatrics, Hanyang University Seoul Hospital) ;
  • Hwang, Jong Hee (Department of Pediatrics, Inje University Ilsan Paik Hospital) ;
  • Shin, Son Moon (Department of Pediatrics, Inje University Busan Paik Hospital) ;
  • Ahn, Yong Min (Department of Pediatrics, Nowon Eulji Medical Center, Eulji University)
  • Received : 2019.04.30
  • Accepted : 2019.11.11
  • Published : 2020.04.15
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Breastfeeding reportedly reduces the overall frequency of infections. Respiratory syncytial virus (RSV), the most common respiratory pathogen in infants, involves recurrent wheezing and has a pathogenic mechanism related to airway structural damage. Purpose: This study aimed to investigate whether breastfeeding has a beneficial effect against RSV-induced respiratory infection compared to formula feeding among infants in Korea. Methods: We retrospectively reviewed the medical records of infants under 1 year of age who were admitted with RSV infection between January 2016 and February 2018 at the department of pediatrics of 4 hospitals. We investigated the differences in clinical parameters such as cyanosis, chest retraction, combined infection, fever duration, oxygen use, oxygen therapy duration, intensive care unit (ICU) admission, and corticosteroid treatment of exclusive breast milk feeding (BMF), artificial milk formula fed (AMF), and mixed feeding (MF) groups. Results: Among the 411 infants included in our study, 94, 161, and 156 were included in the BMF, MF, and AMF groups, respectively. The rates of oxygen therapy were significantly different among the BMF (4.3%), MF (8.1%), and AMF (13.5 %) groups (P=0.042). The odds ratios (ORs) for oxygen therapy was significantly higher in the AMF group than in the BMF group (adjusted OR, 3.807; 95% confidence interval, 1.22-11.90; P=0.021). The ICU admission rate of the BMF group (1.1%) was lower than that of the MF (3.5%) and AMF (4.5%) groups; however, the dissimilarity was not statistically significant (P=0.338). Conclusion: The severity of RSV infection requiring oxygen therapy was lower in the BMF than the AMF group. This protective role of human milk on RSV infection might decrease the need for oxygen therapy suggesting less airway damage.

Keywords

References

  1. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129:e827-41. https://doi.org/10.1542/peds.2011-3552
  2. Cacho NT, Lawrence RM. Innate Immunity and Breast Milk. Front Immunol 2017;8:584. https://doi.org/10.3389/fimmu.2017.00584
  3. Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 2007;(153):1-186.
  4. Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 21th ed. Philadelphia (PA):Saunders/Elsevier, 2019.
  5. Murray J, Bottle A, Sharland M, Modi N, Aylin P, Majeed A, et al. Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study. PLoS One 2014;9:e89186. https://doi.org/10.1371/journal.pone.0089186
  6. Law BJ, Carbonell-Estrany X, Simoes EA. An update on respiratory syncytial virus epidemiology: a developed country perspective. Respir Med 2002;96 Suppl B:S1-7. https://doi.org/10.1016/S0954-6111(02)90076-4
  7. Stein RT, Sherrill D, Morgan WJ, Holberg CJ, Halonen M, Taussig LM, et al. Respiratory syncytial virus in early life and risk of wheeze and allergy by age 13 years. Lancet 1999;354:541-5. https://doi.org/10.1016/S0140-6736(98)10321-5
  8. Henderson J, Hilliard TN, Sherriff A, Stalker D, Al Shammari N, Thomas HM. Hospitalization for RSV bronchiolitis before 12 months of age and subsequent asthma, atopy and wheeze: a longitudinal birth cohort study. Pediatr Allergy Immunol 2005;16:386-92. https://doi.org/10.1111/j.1399-3038.2005.00298.x
  9. Sigurs N, Aljassim F, Kjellman B, Robinson PD, Sigurbergsson F, Bjarnason R, et al. Asthma and allergy patterns over 18 years after severe RSV bronchiolitis in the first year of life. Thorax 2010;65:1045-52. https://doi.org/10.1136/thx.2009.121582
  10. Eiland LS. Respiratory syncytial virus: diagnosis, treatment and prevention. J Pediatr Pharmacol Ther 2009;14:75-85. https://doi.org/10.5863/1551-6776-14.2.75
  11. Mochizuki H, Kusuda S, Okada K, Yoshihara S, Furuya H, Simoes EAF, et al. Palivizumab prophylaxis in preterm infants and subsequent recurrent wheezing. six-year follow-up study. Am J Respir Crit Care Med 2017;196:29-38. https://doi.org/10.1164/rccm.201609-1812OC
  12. Saglani S. Viral infections and the development of asthma in children. Ther Adv Infect Dis 2013;1:139-50. https://doi.org/10.1177/2049936113497202
  13. Nishimura T, Suzue J, Kaji H. Breastfeeding reduces the severity of respiratory syncytial virus infection among young infants: a multi-center prospective study. Pediatr Int 2009;51:812-6. https://doi.org/10.1111/j.1442-200X.2009.02877.x
  14. Chung SH, Kim HR, Choi YS, Bae CW. Trends of breastfeeding rate in Korea (1994-2012): comparison with OECD and other countries. J Korean Med Sci 2013;28:1573-80. https://doi.org/10.3346/jkms.2013.28.11.1573
  15. Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics 2014;134:e1474-502. https://doi.org/10.1542/peds.2014-2742
  16. Tang YW, Graham BS. T cell source of type 1 cytokines determines illness patterns in respiratory syncytial virus-infected mice. J Clin Invest 1997;99:2183-91. https://doi.org/10.1172/JCI119391
  17. Carbonell-Estrany X, Fullarton JR, Rodgers-Gray BS, Gooch KL, Vo PG, Figueras-Aloy J. Can we improve the targeting of respiratory syncytial virus (RSV) prophylaxis in infants born 32-35 weeks' gestational age with more informed use of risk factors? J Matern Fetal Neonatal Med 2015;28:1133-41. https://doi.org/10.3109/14767058.2014.947573
  18. Roine I, Fernandez JA, Vasquez A, Caneo M. Breastfeeding reduces immune activation in primary respiratory syncytial virus infection. Eur Cytokine Netw 2005;16:206-10.
  19. Chiba Y, Minagawa T, Mito K, Nakane A, Suga K, Honjo T, et al. Effect of breast feeding on responses of systemic interferon and virus-specific lymphocyte transformation in infants with respiratory syncytial virus infection. J Med Virol 1987;21:7-14. https://doi.org/10.1002/jmv.1890210103
  20. Lonnerdal B. Breast milk: a truly functional food. Nutrition 2000;16:509-11. https://doi.org/10.1016/S0899-9007(00)00363-4
  21. Choi EJ. Breastfeeding-related social environmental factors and their policy implications. Sejong (Korea): Health and Welfare Forum, Korea Institute for Health and Social Affairs, 2017:72-81.
  22. Dixon DL. The role of human milk immunomodulators in protecting against viral bronchiolitis and development of chronic wheezing illness. Children (Basel) 2015;2:289-304. https://doi.org/10.3390/children2030289
  23. Flores P, Guimaraes J, Videira Amaral JM. Th1 and th2 cytokine expression in nasopharyngeal secretions during acute bronchiolitis in children younger than two years old. Allergol Immunopathol (Madr) 2011;39:3-9. https://doi.org/10.1016/j.aller.2010.03.008
  24. Hussell T, Baldwin CJ, O'Garra A, Openshaw PJ. CD8+ T cells control Th2-driven pathology during pulmonary respiratory syncytial virus infection. Eur J Immunol 1997;27:3341-9. https://doi.org/10.1002/eji.1830271233

Cited by

  1. Respiratory syncytial virus infection: why does disease severity vary among individuals? vol.14, pp.4, 2020, https://doi.org/10.1080/17476348.2020.1724095
  2. Appropriate care for neonates born to mothers with COVID‐19 disease vol.109, pp.9, 2020, https://doi.org/10.1111/apa.15413
  3. THE EXPERIENCE OF TREATMENT THE PATIENTS WITH COMPLICATED VIRAL RESPIRATORY TRACT INFECTIONS: ROLE OF HIGH-CONCENTRATED OXYGEN INHALATIONS ADDING CAMOMILE OIL vol.74, pp.7, 2021, https://doi.org/10.36740/wlek202107116
  4. Breastmilk Feeding during the First 4 to 6 Months of Age and Childhood Disease Burden until 10 Years of Age vol.13, pp.8, 2020, https://doi.org/10.3390/nu13082825